Legislature divided on Haslam's Medicaid expansion push

Gov. Bill Haslam leaves a joint session of the General Assembly in March in which he announced he was working a “Tennessee Plan” in lieu of Medicaid expansion.
Jae S. Lee / The Tennessean Gov. Bill Haslam leaves after making the announcement of his decision on TennCare to a joint session of the state legislature in Nashville, Tenn., Wednesday, March 27, 2013. (PHOTO BY JAE S. LEE / STAFF)(Photo: Jae S. Lee, Jae S. Lee / The Tennessean)

Haslam told reporters on Thursday that he intends to submit a proposal to expand TennCare. The expansion would be paid for with federal funds under the federal Affordable Care Act, which allows states to provide health care to those who make too much money to qualify for Medicaid but not enough to receive tax credits to help them buy coverage on HealthCare.gov.

About 162,000 people fall into that gap, according to the Kaiser Family Foundation.

State Democrats expressed optimism after Haslam's comments that he would soon offer an expansion proposal. But top Republicans remained skeptical, which underlined the high hurdle facing Haslam. Any TennCare expansion would require approval by the legislature.

A Haslam spokesman said the governor doesn't intend to expand Medicaid as it currently exists in the state, but rather wants to leverage federal funds under a plan unique to Tennessee, the details of which haven't been released yet.

Senate Majority Leader Mark Norris, R-Collierville, indicated Haslam has not worked with lawmakers to craft a plan.

"It seems the governor is not very serious about whatever he has in mind regarding Medicaid expansion, because he hasn't conferred with the General Assembly," Norris said.

'Due diligence'

Lt. Gov. Ron Ramsey, R-Blountville, said Haslam is doing his due diligence by exploring expansion.

"This is nothing new. Gov. Haslam is doing his due diligence on this issue, and the legislature has been clear in its opposition to Obamacare," Ramsey said. "While an acceptable compromise remains doubtful, it is the governor's prerogative to exhaust all possibilities."

On the other side of the aisle, Democrats applauded Haslam and said they looked forward to studying the details of his proposal once it is made public. Haslam said he wants to do what "works financially for the state long term."

State Rep. Craig Fitzhugh, the House Democratic leader, called Haslam's remarks a "positive sign."

"I'm sort of an optimistic type of guy," Fitzhugh said, adding that he foresees a scenario in which the General Assembly would approve expansion. "I think the more the public hears about this, the more they know about this, the more they're going to be positive about it.

"We've had a hospital close in my district and others that would over time be put over the edge as well. I think when that bill gets out it's very possible it could pass the House."

Haslam spokesman Dave Smith said, "This is an ongoing conversation about leveraging available federal dollars to cover more working Tennesseans to control costs and improve health outcomes."

Responding to Norris' comment, Smith said the General Assembly is "critical to the process and has to ultimately approve any plan the state would pursue."

But there's a steeper hill to climb in the Senate, where the Ramsey-led supermajority has used opposition to "Obamacare" as a campaign talking point for several election cycles. Heading into the November elections, Democrats have just seven seats there.

Jeff Yarbro, the Democratic nominee to replace Sen. Douglas Henry, said that every day Tennessee delays expanding Medicaid is bad for the state economy and for people's health.

"I haven't served a day in the state Senate. but I think the consequences of inaction are real and they grow larger with each passing week," Yarbro said. "And that's going to be true for every part of the state. I think that as long as people in the legislature think about their constituents instead of the politics, then we will be able to get a serious plan through."

Pennsylvania on Thursday became the 27th state to expand its Medicaid program.